{"id":632833,"date":"2025-07-28T09:30:33","date_gmt":"2025-07-28T13:30:33","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=632833"},"modified":"2025-10-06T14:17:17","modified_gmt":"2025-10-06T18:17:17","slug":"bystolic-for-anxiety","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/bystolic-for-anxiety\/","title":{"rendered":"Does Bystolic work for anxiety?"},"content":{"rendered":"

Bystolic<\/span><\/a> (<\/span>nebivolol<\/span><\/a>) is a brand-name <\/span>beta blocker<\/span><\/a> that is FDA approved for treating <\/span>high blood pressure<\/span><\/a> (<\/span>hypertension<\/span><\/a>). Because this type of drug calms a racing heart by lowering the rate and force of blood pumping through the heart, Bystolic and other beta blockers are sometimes prescribed<\/span> off-label<\/span><\/a> for anxiety. However, Bystolic will not work for all types of anxiety. The best way to know if Bystolic will relieve your anxiety symptoms is to work with a healthcare provider familiar with your medical conditions and the other prescription or over-the-counter medications you take.<\/span><\/p>\n\t\t

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Does Bystolic help with anxiety?\u00a0<\/span><\/h2>\n

In some cases, yes. Bystolic helps calm some <\/span>anxiety symptoms<\/span><\/a>, but it is not a first-line anxiety treatment. It is not an FDA-approved anxiety treatment, and of the beta blockers prescribed off-label for anxiety, Bystolic is not the most common. <\/span>Most studies<\/span><\/a> on beta blockers for anxiety have used <\/span>propranolol<\/span><\/a>, not nebivolol, the active ingredient in Bystolic.\u00a0<\/span><\/p>\n

\u201cI have seen beta blockers help patients <\/span>significantly<\/span><\/i> with situational anxiety,\u201d says <\/span>Chrissie Ott, MD<\/span><\/a>, a dual board-certified integrative internist and pediatrician in Portland, Oregon.\u00a0<\/span><\/p>\n

Here\u2019s why beta blockers work for situational anxiety: <\/span>Beta blockers decrease sympathetic nervous system activity, which is the body’s built-in fight-or-flight response, says<\/span> Sid Khurana, MD<\/span><\/a>, a board-certified psychiatrist and medical director of Nevada Mental Health. People with situational anxiety, such as stage fright, experience a fight-or-flight response\u2014heart <\/span>palpitations<\/span><\/a>, sweating, or shakiness\u2014even when there is no real danger. Bystolic and other beta blockers help calm that overactive response.<\/span><\/p>\n

“One of my favorite success stories with this medication is a mid-40-year-old woman who had been to the ER for chest pain, palpitations, and shortness of breath,\u201d says <\/span>Troy Alexander-EL<\/span><\/a>, MD, board-certified internal medicine and primary care physician in Portland, Oregon. \u201dShe was started on a low-dose beta blocker twice a day, and when she came back a few weeks later, she was smiling, her skin was glowing, and she was finally sleeping.\u201d<\/span><\/p>\n

It\u2019s important to understand that though beta blockers have been used for anxiety for a long time, there is insufficient evidence for the long-term efficacy of<\/span> beta blockers for anxiety disorders<\/span><\/a>. Healthcare providers continue to prescribe beta blockers like Bystolic off-label\u2014meaning, for a use not approved by the FDA\u2014because they can calm or prevent physical anxiety symptoms for patients whose anxiety spikes in specific, predictable situations.\u00a0<\/span><\/p>\n

In other words, Bystolic may relieve physical symptoms of anxiety, but it is not usually healthcare providers’ first choice. Keep in mind that there is a lack of studies on Bystolic for anxiety specifically and a lack of evidence for beta blockers for anxiety in general. It’s important to consult a healthcare professional if you are interested in using Bystolic or another beta blocker for situational anxiety, such as stage fright or fear of flying.<\/span><\/p>\n

How much Bystolic should I take for anxiety?<\/span><\/h2>\n

Bystolic is<\/span> FDA-approved<\/span><\/a> for <\/span>high blood pressure<\/span><\/a>, not anxiety. When taken for hypertension,<\/span> Bystolic dosage<\/span><\/a> ranges from a starting dose of 5 mg to a maximum dose of 40 mg taken orally once per day. However, because Bystolic for anxiety is an off-label use of the drug, there is no set dosing protocol for anxiety. Patients should be aware that this medication may lower a normal blood pressure and cause symptoms of hypotension: dizziness, fatigue, and blacking out.<\/span><\/p>\n

You should only use Bystolic as directed by your healthcare provider. Dosing instructions may be situation-dependent and based on your prescriber’s knowledge of your medical history and health conditions. For instance, if you have performance anxiety or stage fright, your provider may recommend taking Bystolic about 30 minutes before a performance or speaking event. Take precisely the dose recommended\u2014do not take Bystolic more often or in higher doses than prescribed by your healthcare provider.\u00a0<\/span><\/p>\n

How long does it take for Bystolic to work for anxiety?<\/span><\/h2>\n

Beta blockers typically kick in within 20-30 minutes and last for four to six hours, according to Dr. Khurana. Nebivolol reaches its peak concentration<\/span> one to four hours<\/span><\/a> after dose administration<\/a>.\u00a0<\/span><\/p>\n

Because they take time to kick in, Dr. Khurana says beta blockers are most effective for anxiety symptoms when taken before a known anxiety-provoking event rather than to end a <\/span>panic attack<\/span><\/a>. For example, a person with social anxiety might be instructed by their healthcare provider to take a beta blocker before a public speaking event to help keep their heart rate lower throughout the event. Or a person with flight anxiety might take a beta blocker before flying to prevent a fast heartbeat and jitteriness, causing anxiety throughout the flight. Dr. Khurana says you may still experience anxious thoughts and emotions if you take Bystolic or another beta blocker for anxiety. However, physical symptoms such as shakiness, sweating, or a racing or pounding heart should dissipate.<\/span><\/p>\n

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